Individual
MRS. STEPHANIE JO GRINSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1712 HOLTON ROAD, SUITE B, MUSKEGON, MI 49445
(231) 719-1921
(231) 719-9470
Mailing address
1712 HOLTON ROAD, SUITE B, MUSKEGON, MI 49445
(231) 719-1921
(231) 719-9470
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
DIPLOMA ONLY
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30609
BCBS
MI
05
—
4717630
—
MI
Enumeration date
10/04/2006
Last updated
07/08/2007
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